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JCM
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Cirrhosis and Its Complications: Prognosis and Clinical Management
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Cirrhosis and Its Complications: Prognosis and Clinical Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 May 2026 | Viewed by 2280

Special Issue Editor

Dr. Ana-Maria Singeap

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Guest Editor
1. Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania 2. Institute of Gastroenterology and Hepatology, "St. Spiridon" University Hospital, 700111 Iasi, Romania
Interests: metabolic dysfunction-associated steatotic liver disease; cirrhosis; liver transplantation; gastrointestinal bleeding
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cirrhosis remains a major global health burden, with its complications significantly impacting morbidity, mortality, and healthcare systems. This Special Issue will provide a comprehensive overview of the latest advances in prognosis, risk stratification, and clinical management in cirrhosis and its complications, including portal hypertension, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, acute-on-chronic liver failure (ACLF), and hepatocellular carcinoma. A concomitant focus will be placed on the liver transplantation setting, including criteria, patient assessments, and the refinement of follow-up strategies. In addition, we welcome contributions discussing the impact of cirrhosis on patients’ quality of life, exploring how chronic symptoms, comorbidities, and treatment influence overall well-being.

We invite the submission of original research articles, reviews, and clinical perspectives addressing emerging diagnostic tools, biomarkers, novel therapeutic strategies, and multidisciplinary approaches to optimizing patient outcomes. In particular, papers should address challenges faced in individualized treatment, the prevention of disease progression, and the management of comorbidities.

This Special Issue will serve as a valuable resource for hepatologists and all healthcare professionals involved in the care of patients with cirrhosis. By bringing together cutting-edge research articles and expert insights, we aim to advance clinical practice and improve patient prognoses.

Dr. Ana-Maria Singeap
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cirrhosis
  • complications
  • spontaneous bacterial peritonitis
  • portal hypertension
  • ascites
  • hepatorenal syndrome
  • hepatic encephalopathy
  • liver transplantation
  • acute-on-chronic liver failure
  • hepatocellular carcinoma
  • quality of life
  • prognosis
  • clinical management

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Published Papers (2 papers)

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Research

10 pages, 473 KB  
Article
Acute Variceal Bleeding During the SARS-CoV-2 Pandemic: A National Multicenter Observational Study
by Gabriel Allo, Stefanie Quickert, Karsten Große, Sidar Baysal, Dirk Nierhoff, Christoph Neumann-Haefelin, Christoph Schramm, Tony Bruns, Philipp Alexander Reuken and Martin Bürger
J. Clin. Med. 2025, 14(17), 6166; https://doi.org/10.3390/jcm14176166 - 31 Aug 2025
Viewed by 874
Abstract
Background: The COVID-19 pandemic disrupted healthcare systems globally, raising concerns about its negative impact on patients with chronic liver diseases by contributing to hepatic decompensations such as acute variceal bleeding (AVB). This study aimed to evaluate the impact of the COVID-19 pandemic [...] Read more.
Background: The COVID-19 pandemic disrupted healthcare systems globally, raising concerns about its negative impact on patients with chronic liver diseases by contributing to hepatic decompensations such as acute variceal bleeding (AVB). This study aimed to evaluate the impact of the COVID-19 pandemic on clinical outcomes in cirrhotic patients with AVB in Germany. Methods: This retrospective national multicenter study compared patients with cirrhosis and AVB treated at four tertiary care centers in Germany before (2016–2020) and during the pandemic (2020–2022). The primary endpoint was 6-week mortality, and secondary outcomes included infections, transfusion requirement and rebleeding. Results: The baseline characteristics of the 247 patients were largely comparable between the two groups, however metabolic dysfunction-associated steatotic liver disease was more prevalent during the pandemic compared to the pre-pandemic period (12.5% vs. 4.8%, p = 0.048). Only one patient tested positive for SARS-CoV-2. Six-week mortality (32.2% vs. 30.1%; p = 0.767) and rebleeding rates (22.8% vs. 22.3%; p = 1.000) did not differ significantly between groups. Interestingly, intubation rates, length of stay on the intensive care unit, post AVB infection rates and types of infection were also comparable (all p > 0.05), while transjugular intrahepatic portosystemic shunt placement (TIPS) after bleeding was performed more frequently during the pandemic (23.2% vs. 11.3%, p = 0.019). Conclusions: Relevant patient-related AVB outcomes were unaffected during the COVID-19 pandemic. These findings suggest the resilience of critical AVB management practices in German tertiary centers. The increased use of TIPS and MASLD prevalence during the pandemic may reflect evolving clinical practice and patient profiles warranting further investigation. Full article
(This article belongs to the Special Issue Cirrhosis and Its Complications: Prognosis and Clinical Management)
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11 pages, 1176 KB  
Article
Clinically Important Decrease in Liver Stiffness Following Treatment for Hepatitis C: Outcome of the TraP HepC Nationwide Elimination Program
by Smári Freyr Kristjánsson, Sigurdur Olafsson, Magnús Gottfredsson, Thorvardur Jon Love and Einar Stefán Björnsson
J. Clin. Med. 2025, 14(11), 3982; https://doi.org/10.3390/jcm14113982 - 5 Jun 2025
Viewed by 1061
Abstract
Background/Objectives: Direct-acting antiviral (DAA) therapy has been highly successful in treating chronic hepatitis C (CHC). The nationwide Treatment as Prevention of Hepatitis C (TraP HepC) initiative that was launched in Iceland in 2016 utilized liver stiffness measurements (LSM) to assess liver fibrosis at [...] Read more.
Background/Objectives: Direct-acting antiviral (DAA) therapy has been highly successful in treating chronic hepatitis C (CHC). The nationwide Treatment as Prevention of Hepatitis C (TraP HepC) initiative that was launched in Iceland in 2016 utilized liver stiffness measurements (LSM) to assess liver fibrosis at baseline and follow-up. We aimed to determine changes in liver stiffness among patients following treatment with DAAs and evaluate risk factors associated with hepatic fibrosis. Methods: Eligible CHC patients with liver stiffness of >9.5 kilopascals (kPa) before DAA treatment were invited for a follow-up visit in 2024. Risk factors for cirrhosis were registered, LSM performed, and liver enzymes, blood lipids, and glucose levels measured. Changes in liver stiffness were compared to baseline measurements, and correlations with risk factors were analyzed. Results: A total of 96 patients had LSMs > 9.5 kPa at treatment initiation. During the follow-up period, 61 were eligible for participation, 38 consented, and 34 (35%) died. The total follow-up was 258.3 person-years. The median follow-up period between measurements was 7.1 years. The median liver stiffness decreased from 17.2 kPa to 7.3 kPa (p < 0.01), and 80% of those with cirrhosis (>12.5 kPa) regressed to non-cirrhotic values. High BMI and daily alcohol consumption were significantly associated with increased liver stiffness in 8% of patients. Conclusions: In this single-arm, pre-post pilot study, liver stiffness regressed significantly in 92% of patients who were cured of CHC. Patients with other persistent risk factors following cure, such as obesity and alcohol abuse, were the only patients who had increased liver stiffness at the end of follow-up. Full article
(This article belongs to the Special Issue Cirrhosis and Its Complications: Prognosis and Clinical Management)
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